前立腺癌による死亡前2年間に治療を必要とした症状の検討

Abstract

We conducted a study of the symptoms of prostate cancer that required medical treatment in terminal patients intermittently hospitalized over a period of two years. We examined the medical records of 54 out of 55 patients who died of prostate cancer between January 2000 and December 2008. The period from the initial visit to death was between 6 and 179 months (median : 48 months). The frequency of hospitalization per patient within two years before death was between 0 and 12 times (median : 3 times). The leading causes of hospitalization (a total of 191 times) were pain (44 times), a poor physical condition (30 times), hematuria (23 times), cancer treatment (22 times), anemia (18 times), and urinary retention (12 times). Thirty-two cases required the use of opioids (0.5 to 25 months before death, median : 5 months), 25 cases required blood transfusion (0.5 to 24, median : 5 months), 17 cases required long-term catheterization (0.5 to 16, median : 4 months), 10 cases required external beam radiation (2 to 25, median : 15 months), 6 cases required percutaneous nephrostomy (0.5 to 7, median : 2 months), three cases required transurethral resection of the prostate (3 to 23, median : 23 months), and two cases required fracture fixation (5 to 6 months before death). Since urologists are in charge of patients from their initial visit to the terminal stage, they are required not only to immediately address, or prevent if possible, these symptoms appearing in the terminal stage, but also to help enhance the quality of life of patients by providing palliative care based on expert knowledge.